Music Therapy for Neurological Disorders

Music Therapy for Emotional Regulation

As Danny enters the Music Therapy room at the end of the school day, he jumps, flaps his hands and vocalizes in a stressed manner wrinkling up his face and letting the therapist know that he is anything but happy.  The therapist moves the sharp symbol from its location so the environment is safe for Danny to move in it while he works through his emotions.   Danny goes directly to the trampoline and continues his jumping with vigor.  The therapist immediately goes to the piano and matches Danny’s jumping rhythm and structures Danny’s typical “Theme Song” around his vocalizations.

Music Therapy for autism symptoms & emotional regulationsThe therapist reflects the intensity of his vocalizations through the dynamics and attack on the keys.  She then begins to vocalize with Danny. Danny’s vocalizations follow tones close to G-G-G-G-B-C increasing his volume and sustaining the top C tone.  The therapist reflects that phrase and then in the space before Danny’s next vocal, she plays a low G as a pickup to Danny’s tune.  Repeating this, Danny begins to wait for that pickup.  As the two get into a repetitive joint groove, the therapist observes Danny’s tempo and intensity decreasing. She reflects this in the music and then places her low G, sustains it and sings back a three-note phrase utilizing that same G that leads Danny’s vocalizations.

She watches Danny, sustaining and holding the tone as he comes in softer with his beginning G tone.  She has helped Danny establish intentionality behind his vocalizations, a two-way communication.  As the interaction continues this way, she wants to give Danny an opportunity to add and develop more.  The therapist had reflected Danny’s intensity of motion utilizing the tones he produced and gave them a musical structure.

As she repeated this process, Danny was pulled into a predictable structure and having been heard and allowed to speak the intensity of his emotions with another in a structure began to calm himself.  As the therapist put in her own brief tones that joined and led back to Danny’s musically, Danny repeated the predictable structure and the outlash of emotions now became an interactive musical dialog.

As the interaction continued this way, the therapist wanted to give Danny an opportunity to grow and move beyond this initial emotional response.  She did her three-tone melody then stopped the music and watched.  Danny continued his musical emotional structure.  The therapist tried her three-note musical response again.  This time, repeating that last tone three times with vigor.  Danny watched but again repeated his little melody.  The therapist tried this again increasing the intensity of this now six-note phrase.  This time Danny put his hands on his head and jumping then very loudly added a couple more vocal tones not heard previously.  It was like the cap came off the soda can.

As he continued his vocals, he sat down on the trampoline and then repeated his vocals but this time softer and slower.   The next time the therapist repeated the process she made sure that she included his new additional tones.  Danny now demonstrated a softer, quieter and more controlled demeanor.  He did not name his emotions, and he wasn’t removed from the situation.  Danny was heard, joined and given an opportunity to extend his thought and therefore shared attention and engaged with the therapist and eventually when given a few opportunities began a two-way intentional vocal.

As the therapist began the goodbye song, Danny walked over to the piano bench and sat with her.  On the last “goodbye”, Danny softly and pleasantly grunted a “bye”.  Danny exited the session with a completely different energy and demeanor.  The emotion was allowed to emerge and as the therapist listened, watched and set up the musical structure around what Danny presented, then altered the dynamics and expectation of one tone, Danny began to respond and calm attending independently to the therapist.  Danny regulated his own emotions through relating in the music and expansion beyond the explosiveness.  In the music, patience and persistence continued attending to Danny’s individual preferences and differences.


Music Therapy for Sharing Attention

As the little boy comes into the Music Therapy room and moves from one thing to another while running, tapping his belly with both hands, briefly jumping on the trampoline and then going to the mirror, the Music Therapist improvises a brief tune following the tempo of his running feet hitting the floor and then jumping on the trampoline.  She sees that this fast tempo along with the agitated quick sounds excites and alerts the boy.  She inserts lots of runs and ornamentation following his lead to increase his attention to the music further.

As his excitement increases, his silence breaks into a giggle and a loud “ah” as his feet hit the floor jumping off the trampoline.  As he begins to look at her, she notices how far away she is from the boy.  She decides to move from the piano and grabs a small ukulele to move with him, keeping the basic tune going but singing the melody on a “la, la, la” as she follows him around the room.  The little boy giggles and laughs enjoying this other person joining him.  His random unfocused quick movements are now being done purposely as the therapist gives musical structure to what he is doing.

Now both the music and the little boy’s movements have predictability.  The therapist takes a chance to make this a little more interactive process.  She grabs the microphone and starts singing into it.  At the end of the phrase, she puts the microphone in front of the boy.  First he just looks at it and puts his mouth on it.  Not to lose his focus, she repeats the process to the same little tune and this time after putting his mouth on the microphone, he makes a “shush” sound.   Once again, in order to keep him in the process, she repeats the tune only instead of singing “la”, she vocalizes “shush” then again puts the microphone in front of him at the end of the phrase.

This time he giggles.  She repeats the process again and only this time uses the vocalizations of his giggling sounds to sing.  As she leaves off the end of the phrase, he now intentionally howls “bah!” into the microphone laughing all the more.  The therapist remains persistent in this process keeping individual differences and preferences in mind while continuing to think about how to pull in this boy even more and ask more of him as they continue.